Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort.
Barcelona clinic liver cancer nomogram and others staging/scoring systems in a French hepatocellular carcinoma cohort.
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DOI：
10.3748/wjg.v23.i14.2545
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发表时间：
2017-04-14
影响因子：
4.3
通讯作者：
Bourlière M
中科院分区：
文献类型：
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作者：
Adhoute X;Pénaranda G;Raoul JL;Edeline J;Blanc JF;Pol B;Campanile M;Perrier H;Bayle O;Monnet O;Beaurain P;Muller C;Castellani P;Le Treut YP;Bronowicki JP;Bourlière M
比较巴塞罗那临床肝癌（BCLC）列线图和其他系统（BCLC、HKLC、CLIP、NIACE）在法国大型肝细胞癌（HCC）队列中的生存预测性能。从2007年1月至2013年12月在5家法国临床试验机构回顾性收集数据。分析了新诊断的HCC患者。比较各评分系统的区分能力、同质性能力、预后分层能力、赤池信息标准（AIC）和C指数。该队列包括1102例患者，大多数为男性，中位年龄68 [60-74]岁，肝硬化（81%），Child-Pugh A（73%），酒精相关（41%），HCV相关（27%）。HCC为多结节性（59%），41%的病例存在血管浸润。在HCC诊断时，BCLC分期为A（17%）、B（16%）、C（60%）和D（7%）。在我们的人群中，23.5%的一线HCC治疗是治愈性的，59.5%是姑息性的，17%是BSC。中位OS为10.8个月[4.9-28.0]。各系统区分不同的生存预后组（P < 0.0001）。列线图的判别能力最强，C指数值最高。NIACE评分的AIC值最低。列线图区分16个不同的预后组。通过将单灶性大HCC分类为肿瘤负荷1，诺模图的效力较低。在这个法国队列中，BCLC列线图和NIACE评分提供了最好的预后信息，但NIACE甚至可以帮助治疗策略。
To compare the performances of the Barcelona clinic liver cancer (BCLC) nomogram and others systems (BCLC, HKLC, CLIP, NIACE) for survival prediction in a large hepatocellular carcinoma (HCC) French cohort. Data were collected retrospectively from 01/2007 to 12/2013 in five French centers. Newly diagnosed HCC patients were analyzed. The discriminatory ability, homogeneity ability, prognostic stratification ability Akaike information criterion (AIC) and C-index were compared among scoring systems. The cohort included 1102 patients, mostly men, median age 68 [60-74] years with cirrhosis (81%), child-Pugh A (73%), alcohol-related (41%), HCV-related (27%). HCC were multinodular (59%) and vascular invasion was present in 41% of cases. At time of HCC diagnosis BCLC stages were A (17%), B (16%), C (60%) and D (7%). First line HCC treatment was curative in 23.5%, palliative in 59.5%, BSC in 17% of our population. Median OS was 10.8 mo [4.9-28.0]. Each system distinguished different survival prognosis groups (P < 0.0001). The nomogram had the highest discriminatory ability, the highest C-index value. NIACE score had the lowest AIC value. The nomogram distinguished sixteen different prognosis groups. By classifying unifocal large HCC into tumor burden 1, the nomogram was less powerful. In this French cohort, the BCLC nomogram and the NIACE score provided the best prognostic information, but the NIACE could even help treatment strategies.